Effect of primary, cross-over, zigzag neopharyngoplasty on acoustic characteristics of alaryngeal, tracheoesophageal voice

2011 ◽  
Vol 125 (8) ◽  
pp. 841-848 ◽  
Author(s):  
O A Albirmawy
Keyword(s):  
Total Laryngectomy ◽  
Dynamic Range ◽  
Speaking Rate ◽  
University Hospital ◽  
Pharyngocutaneous Fistula ◽  
Acoustic Parameters ◽  
Tertiary Referral Centre ◽  
Voice Restoration ◽  
Fundamental Frequencies ◽  
Temporal Measures

AbstractObjective:To evaluate the effect of primary, cross-over, zigzag neopharyngeal construction on tracheoesophageal voice, compared with pharyngoesophageal myotomy, following total laryngectomy with partial pharyngectomy.Study design:Prospective clinical trial.Setting:Otolaryngology department, Tanta University Hospital (tertiary referral centre), Egypt.Patients and methods:Over five years, 30 patients underwent total laryngectomy with partial pharyngectomy to manage stage III or IV laryngeal cancer, followed by primary tracheoesophageal puncture for voice restoration. For neopharyngeal construction, 15 patients underwent pharyngoesophageal myotomy (group one) and 15 cross-over, zigzag neopharyngoplasty (group two). Acoustic parameters of tracheoesophageal voice were compared.Results:Most acoustic parameters were almost equivalent for the two groups, although significant differences were seen for loud intensity, dynamic range, shimmer, loud fundamental frequency, loud jitter, fluency and speaking rate. One post-operative pharyngocutaneous fistula (6.6 per cent) occurred in each group, and resolved with conservative measures.Conclusion:The cross-over neopharyngoplasty modification of hypopharyngeal closure may help avoid pharyngoesophageal spasm and assist maintenance of effective voice amplitude, fundamental frequencies, temporal measures and perceptual values.

Effect of primary neopharyngeal repair on acoustic characteristics of tracheoesophageal voice after total laryngectomy

2008 ◽  
Vol 123 (4) ◽  
pp. 426-433 ◽  
Author(s):  
O A Albirmawy ◽  
A S El-Guindy ◽  
M N Elsheikh ◽  
M E Saafan ◽  
M E Darwish
Keyword(s):  
Total Laryngectomy ◽  
Speaking Rate ◽  
Voice Rehabilitation ◽  
Muscle Repair ◽  
Mean Values ◽  
Voice Restoration ◽  
Pharyngeal Plexus ◽  
Significant Difference ◽  
Tracheoesophageal Puncture ◽  
Repair Group

AbstractObjectives:The tracheoesophageal puncture technique of voice restoration enables successful voice rehabilitation after total laryngectomy. Because post-operative voice quality can vary significantly, depending on which type of hypopharyngeal repair is chosen, the aim of this study was to evaluate the effect of such repair on tracheoesophageal puncture voice after total laryngectomy.Study design:Prospective, clinical study.Setting:Otolaryngology department, Tanta University, Egypt.Methods:Tracheoesophageal puncture voice was quantitatively and qualitatively evaluated in 40 patients using a Provox 2TM prosthesis after standard total laryngectomy. The patients were divided, according to the type of hypopharyngeal repair, into four groups of 10 cases each, as follows: group one, pharyngoesophageal myotomy; group two, pharyngeal plexus neurectomy; group three, non-muscle vertical repair; and group four, transverse repair. These surgical groups were compared with each other with respect to different voice parameters.Results:Patient profiles were almost equivalent in all surgical groups. The mean values of most of the parameters of quantitative tracheoesophageal puncture voice did not differ significantly, comparing the four surgical groups; however, a slightly significant difference was observed regarding loud intensity in the non-muscle repair group, and soft and loud jitter in the transverse repair group. Mean values for qualitative measures of intelligibility and communicative effectiveness did not show significant difference. However, a slightly significant difference was observed regarding fluency, word correctness, speaking rate and wetness, with higher values for all these parameters except wetness in the myotomy group, and higher values for wetness in the non-muscle repair group.Conclusion:The four hypopharyngeal repair types – primary pharyngoesophageal myotomy, pharyngeal plexus neurectomy, non-muscle vertical repair and transverse hypopharyngeal repair – were almost equivalent in prevention of pharyngoesophageal spasm in total laryngectomy patients who had undergone primary tracheoesophageal puncture for voice restoration.

Postlaryngectomy Pharyngocutaneous Fistula: Incidence, Predisposing Factors, and Therapy

2005 ◽  
Vol 133 (5) ◽  
pp. 689-694 ◽  
Author(s):  
Jacopo Galli ◽  
Eugenio De Corso ◽  
Mariangela Volante ◽  
Giovanni Almadori ◽  
Gaetano Paludetti
Keyword(s):  
Risk Factor ◽  
Total Laryngectomy ◽  
Radical Neck Dissection ◽  
Predisposing Factors ◽  
Spontaneous Closure ◽  
Pharyngocutaneous Fistula ◽  
Systemic Diseases ◽  
Surgical Closure ◽  
Number Of Factors ◽  
Wait And See

OBJECTIVE: The pharyngocutaneous fistula (PCF) is a serious complication after total laryngectomy, and its etiology is not well understood yet. The aim of our study was to evaluate predisposing factors, incidence, and management of this complication. STUDY DESIGN AND SETTING: This was a retrospective study of 268 patients who underwent total laryngectomy in our clinic (January 1990-December 2001). A number of factors potentially predisposing to PCF formation were evaluated. RESULTS: A PCF was observed in 16% of patients. Systemic diseases, previous radiotherapy, supraglottic origin of tumor, and concurrent radical neck dissection were significantly associated with PCF. Spontaneous closure was noted in 28 patients, whereas a surgical closure was necessary in 15 patients. CONCLUSIONS: In presence of a specific risk factor, PCF can be expected; nevertheless, its prevention remains very difficult. Moreover, given the high percentage of spontaneous closure, we suggest the “wait and see” approach for 28 days before proceeding with a surgical approach.

Pharyngocutaneous Fistula after Total Laryngectomy: Incidence, Cause, and Treatment

1994 ◽  
Vol 103 (10) ◽  
pp. 801-805 ◽  
Author(s):  
George Papazoglou ◽  
George Terzakis ◽  
George Doundoulakis ◽  
George Dokianakis
Keyword(s):  
Total Laryngectomy ◽  
Major Complication ◽  
Predisposing Factors ◽  
Morbidity And Mortality ◽  
Red Cross ◽  
Pharyngocutaneous Fistula ◽  
Common Complication ◽  
Methods Of Treatment

Postoperative pharyngocutaneous fistula is a major complication of total laryngectomy that prolongs the short hospitalization of 2 to 3 weeks to many weeks or even months. It is a common complication that increases the morbidity and mortality of the procedure. In the Department of Otolaryngology of the Red Cross Hospital of Athens, 310 patients underwent total laryngectomy from January 1980 through December 1989. Twenty-eight patients developed a fistula (incidence 9%). The incidence, predisposing factors, and methods of treatment of this complication are analyzed and discussed.

scholarly journals P100 EARLY POSTOPERATIVE WOUND COMPLICATIONS AFTER MIDLINE LAPAROTOMY CLOSURE WITH SMALL BITES TECHNIQUE: EXPERIENCE FROM A TERTIARY REFERRAL CENTRE

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Adomas Gudelis ◽  
Gintaras Simutis ◽  
Julius Pacevicius
Keyword(s):  
Abdominal Wall ◽  
Surgical Site Infections ◽  
Wound Dehiscence ◽  
Patient Characteristics ◽  
University Hospital ◽  
Wound Complications ◽  
Tertiary Referral Centre ◽  
Midline Laparotomy ◽  
Group A ◽  
Wound Length

Abstract Aim To analyze the incidence and risk factors of surgical site infections (SSI) and wound dehiscence (WD) after closure of primary midline laparotomies with small-bites (SB) technique. Material and Methods Retrospective analysis using hospital prospective database of all midline abdominal wall closures (AWC) with SB technique performed in a University Hospital between December 2019 and February 2021. To achieve a proper protocol of AWC with SB technique, it is advised to have suture/wound length (SL/WL) – ratio of more than 4:1. Statistical analysis of the incidence of SSI and AWD, comparing the results when the protocol was properly used (A group) or not (B group), was performed. Between groups, no relevant differences were observed for patient characteristics. Results A total of 108 midline laparotomies were included for analysis. 55.5% of patients were male. The mean age was 62.8 years, mean body mass index was 24.3 kg/m2. 78.7% (85/108) were operated electively. SSI and WD have been recorded in 7 (6.5%) and 8 (7,4%) cases respectively. In 65 (60,2%) patients abdominal wall closure after primary laparotomy was achieved with proper protocol (group A). Median SL/WL in A and B group was 4.57 and 3.43 respectively. The rate of WD in A group (n = 1, 1,5%) was significantly (P=.006) lower than in B group (n = 7, 16,3%). Incidence of SSI was 7,7% (n = 5, A group) vs. 4,7% (n = 2; B group) (P=.420). Conclusions Using a proper AWC protocol has been effective to prevent WD in midline laparotomy.

Early oral hydration protects against pharyngocutaneous fistula after total laryngectomy or total pharyngolaryngectomy

Head & Neck ◽  
2020 ◽  
Vol 42 (8) ◽  
pp. 1902-1906 ◽  
Author(s):  
Matthieu Le Flem ◽  
Laure Santini ◽  
Carole Boulze ◽  
Abdallah Alshukry ◽  
Antoine Giovanni ◽  
...  
Keyword(s):  
Total Laryngectomy ◽  
Pharyngocutaneous Fistula ◽  
Oral Hydration ◽  
Total Pharyngolaryngectomy

Utility of the Montgomery salivary tubes for preventing pharyngocutaneous fistula in total laryngectomy

2020 ◽  
Vol 41 (4) ◽  
pp. 102557
Author(s):  
Pablo Torrico Román ◽  
Agustín García Nogales ◽  
Gabriel Trinidad Ruíz
Keyword(s):  
Total Laryngectomy ◽  
Pharyngocutaneous Fistula
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